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Report Smokefree Air Act Violation

When filling out this forms, required fields are indicated by an asterisk (*). If you are having trouble filling out this form, please call 294-8090.

Step 1: Your Contact Information

First Name*:

Last Name*:

Campus address:

Campus phone:

Email*:

Step 2: Complaint Information

Violator First Name: (if known)

Violator Last Name: (if known)

Location of Violation*:

Date of Violation*:

Time of Violation*:

Description of Violation*:

This service is intended to report violations at Iowa State University ONLY.